Medical Claims & Revenue Cycle Specialist

WVU Medicine; Charleston (WV); On-site; USD 42,000 - 64,000; Full time

Job summary

SYSTEM West Virginia University Health System in Charleston, WV is seeking a Billing Specialist to manage patient account balances, submit claims, and follow up with third-party payers. The role emphasizes compliance with HIPAA and state/federal regulations, accurate billing, and denial management to support the WVU Medicine hospitals.

You will collaborate with Patient Access and Care Management, prepare reports, and help meet department goals through efficient daily tasks and strong customer

Qualifications

• High School diploma or equivalent required.
• At least 1 year medical billing/office experience preferred.
• Knowledge of HIPAA and privacy practices helpful.

Responsibilities

• Submit accurate, timely claims to third-party payers.
• Resolve claim edits and account errors before submission.
• Follow up with payers to ensure collections and meet goals.
• Gather statistics, generate reports, perform duties as assigned.
• Prioritize daily tasks for productivity and efficiency.
• Ensure HIPAA compliance regarding PHI and submissions.
• Contact payers to resolve unpaid claims.
• Use payer portals to verify status and follow up.
• Assist with denial investigations and resolutions.
• Participate in required training programs.
• Attend department meetings and webinars.
• Reconcile billing transactions to maintain accuracy.
• Process billing and follow-up transactions timely.
• Maintain knowledge of regulations governing hospital billing.
• Monitor accounts to optimize cash receipts.
• Maintain queue volumes within guidelines.
• Provide excellent customer service to patients and staff.
• Contribute to performance improvement initiatives.
• Collaborate with supervisor to meet annual goals.
• Maintain confidentiality of patient data.
• Report workflow issues to management.

Skills

Communication skills

Customer service

Telephone etiquette

Medical terminology

Education

High School diploma or equivalent

Tools

Payer portals

Billing software

Job description

SYSTEM West Virginia University Health System in Charleston, WV is seeking a Billing Specialist to manage patient account balances, submit claims, and follow up with third-party payers. The role emphasizes compliance with HIPAA and state/federal regulations, accurate billing, and denial management to support the WVU Medicine hospitals.

You will collaborate with Patient Access and Care Management, prepare reports, and help meet department goals through efficient daily tasks and strong customer